| Doctor Name: | MICHAEL SPENCER GIBSON |
| NPI Number: | 1447246640 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | D54010 |
| Business Practice Address: | Nnmc, Radiology 8901 Wisconsin Ave Bethesda, MD - 208890001 |
| Business Phone Number: | 3012955050 |
| Business Fax Number: | |
| Mailing Address: | 4060 Fairmount Ave, SAN DIEGO |
| State: | CA |
| Postal Code: | 921051608 |
| Phone Number: | 6199974859 |
| Fax Number: | |
| NPI Enumeration Date: | 09/22/2005 |
| NPI Last Update Date: | 04/30/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | D54010 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |